Regional (spinal or epidural anesthesia). Medicine is put into your back to make you numb below your waist. You will also get medicine to make you sleepy. And you may get medicine that will make you forget about the procedure, even though you will not be fully asleep.

After you receive anesthesia, your surgeon will make a surgical cut to open up your hip joint. Often this cut is over the buttocks. Then your surgeon will:

Cut and remove the head of your thigh bone

Clean out your hip socket and remove the rest of the cartilage and damaged or arthritic bone

Put the new hip socket in place, then insert the metal stem into your thigh bone

Place the correct-sized ball for the new joint

Secure all of the new parts in place, sometimes with a special cement

Repair the muscles and tendons around the new joint

Close the surgical cut

This surgery usually takes 1 to 3 hours.

Why the Procedure Is Performed

The most common reason to have a hip joint replaced is to relieve severe arthritis pain that is limiting your activities.

Hip joint replacement is usually done in people age 60 and older, but many people who have this surgery are younger. Younger people who have a hip replaced may put extra stress on the artificial hip. That extra stress can cause it to wear out. Part or all of the joint may need to be replaced again if that happens.

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

Prepare your home.

Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.

You may also need to stop taking medicine that can make you more likely to get an infection. This includes methotrexate, Enbrel, and other medicines that suppress your immune system.

Ask your doctor which drugs you should still take on the day of your surgery.

If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the doctor who treats you for these conditions.

Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.

If you smoke, you need to stop. Ask your doctor or nurse for help. Smoking will slow down wound and bone healing.

Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery.

You may want to visit a physical therapist to learn some exercises to do before surgery and to practice using crutches or a walker.

Set up your home to make everyday tasks easier

Practice using a cane, walker, crutches, or wheelchair correctly to:

Get in and out of the shower

Go up and down stairs

Sit down to use the toilet and stand up after using the toilet

Use the shower chair

On the day of your surgery:

You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.

Take the drugs your doctor told you to take with a small sip of water.

After the Procedure

You will stay in the hospital for 2 - 3 days. During that time you will recover from your anesthesia, and from the surgery itself. You will be asked to start moving and walking as soon as the first day after surgery.

Some people need a short stay in a rehabilitation center after they leave the hospital and before they go home. At a rehab center, you will learn how to safely do your daily activities on your own. Home health services are also available.

Outlook (Prognosis)

Hip replacement surgery results are usually excellent. Most or all of your pain and stiffness should go away.

Some people may have problems with infection, loosening, or even dislocation of the new hip joint.

Over time -- sometimes as long as 15 - 20 years -- the artificial hip joint will loosen. You may need a second replacement.

Younger, more active people may wear out parts of their new hip. It may need to be replaced before the artificial hip loosens.

References

Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopaedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest. 2009;135:513-520.